Association Between Duration of Macular Edema and Clinical Outcomes in Patients with BRVO Following Treatment with Dexamethasone Intravitreal Implant

1. Paul Mitchell¹
2. Tien Y. Wong²
3. Julia A. Haller³
4. Scott W. Whitcup⁴
5. Jonathan W. Kowalski⁴
6. Wei-Shi Yeh⁴

¹University of Sydney, Sydney, Australia
²Singapore Eye Research Institute, Singapore
³Wills Eye Institute, Philadelphia, PA, U.S.A.
⁴Allergan Inc., Irvine, CA, U.S.A.

Purpose: This analysis assesses the association of duration of macular edema (ME) with visual and anatomic outcomes following dexamethasone 0.7 mg Implant (DEX) treatment in patients with vision loss due to ME following BRVO.

Methods: This post hoc analysis includes 459 BRVO DEX-treated patients enrolled in the GENEVA trials. Logistic regression models assessed the association between duration of ME at the time of initial DEX treatment with gaining ≥15-letters in best corrected visual acuity (BCVA) and ≥200 µm reduction in OCT 180 days post treatment. Duration of ME was defined as the time (months) between diagnosis of ME and initial DEX treatment. Age, gender, optical coherence tomography (OCT), and BCVA at treatment were adjusted for in the analyses.

Results: Controlling for all other variables, ME duration at initial DEX treatment was statistically significantly associated with both BCVA and OCT outcomes 180-days post treatment. Each month increase in duration of ME was associated with a significantly lower odds of achieving ≥15-letters improvement in BCVA (OR=0.86, 0.80-0.93) or ≥200 µm reduction in OCT (OR=0.87, 0.80-0.94).

Conclusions: A longer duration of ME at time of DEX treatment is associated with a significantly lower likelihood of achieving ≥15 letter BCVA improvement or ≥200 µm reduction in OCT post-treatment. Therefore, physicians may consider advising patients with BRVO that early DEX treatment may yield the most optimal vision or anatomic outcomes.